Discussions about prognosis, transitions to palliative care, and the end of life are—to say the least—challenging for patients and providers. But effective, honest, and supportive communications are keys to good clinical care and informed decision-­making, according to Dame Lesley Fallowfield, FMedSci, DPhil, Professor of Psycho Oncology, Sussex Health Outcomes Research & Education in Cancer, University of Sussex, Brighton, England.
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The prevalence of fatigue is very high across the cancer continuum, with approximately 60% of patients with advanced cancer experiencing this condition. Even for patients with curable cancer, fatigue can persist well after treatment has ended.
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The largest-ever study of palliative care trends has shown the use of palliative care services to be “sporadic at best” for patients with hematologic malignancies. According to the review of nearly 300,000 patients, there was also significant heterogeneity in practice patterns, including National Cancer Institute (NCI)-designated practices, across all characteristics studied.
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A recent survey by Consumer Reports shows that nearly 90% of Americans prefer to die at home, focused on comfort, and yet 66% of Americans aged >65 years die in a healthcare setting, intubated and in considerable pain. According to Angelo E. Volandes, MD, MPH, Internal Medicine Physician, Massachusetts General Hospital, Boston, this misalignment between the medical care people want and the care they ultimately receive is the most urgent problem in American healthcare today.
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Direct oral anticoagulants (DOACs) may soon replace low-molecular-weight heparin (LMWH) as the standard of care for the management of venous thromboembolism (VTE) in patients with cancer, judging by the results of 2 randomized trials presented at ASH 2017. The caveat is that DOACs are associated with more bleeding events, especially in patients with gastrointestinal (GI) cancer who should continue receiving LMWH.
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On January 12, 2018, the FDA approved a new indication for olaparib (Lynparza; AstraZeneca) for the treatment of women with deleterious or suspected deleterious germline BRCA-positive, HER2-negative, metastatic breast cancer who received previous chemotherapy in the neoadjuvant, adjuvant, or metastatic setting.
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On February 7, 2018, abiraterone acetate (Zytiga; Janssen Biotech) received FDA approval for use, in combination with prednisone, for the treatment of patients with metastatic, high-risk castration-sensitive prostate cancer (CSPC). The FDA approved this new indication under its priority review program.
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On February 14, 2018, apalu­tamide (Erleada; Janssen Pharmaceuticals), an androgen receptor inhibitor, received accelerated approval by the FDA for the treatment of patients with nonmetastatic, cas­tration-resistant prostate cancer (CRPC). Apalutamide is the first treatment approved by the FDA for patients with nonmetastatic CRPC, and was approved under the FDA priority review process.
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On February 16, 2018, the FDA approved an expanded indication for durvalumab (Imfinzi; AstraZeneca), a PD-L1 inhibitor, for the treatment of patients with unresectable stage III non–small-cell lung cancer (NSCLC) that did not progress after chemoradiation. Durvalumab received accelerated approval in 2017 for the treatment of certain patients with metastatic or locally advanced bladder cancer.
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Patients with chronic myeloid leukemia (CML) may be living longer thanks to improved therapies, but the results of a new study suggest that they are burdened by ongoing symptoms and treatment side effects. According to data presented at ASH 2017, fatigue, muscle aches, sleep disturbance, and memory loss were reported by 70%, 57%, 46%, and 42% of patients, respectively.
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Adding brentuximab vedotin (Adcetris) to doxorubicin, vinblastine, and dacarbazine (A+AVD) instead of the standard regimen with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) as frontline treatment for advanced Hodgkin lymphoma reduced the risk for disease progression, death, or the need for additional therapy by 23%, according to new data presented at ASH 2017.
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Despite major advances in treatment interventions, multiple myeloma remains incurable in the majority of patients, and relapse is an expected part of the disease course. At the 2017 NCCN Hematologic Malignancies Congress, Natalie S. Callander, MD, a hematologist at the University of Wisconsin Carbone Cancer Center, Madison, outlined issues in the management of relapsed or refractory multiple myeloma.
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The following clinical trials represent a selection of key studies that are currently recruiting patients with different types of lymphoma for inclusion in investigations of new therapies as well as new regimens of existing treatments for patients with lymphoma. Each description includes the NLM Identifier to be used as a reference with ClinicalTrials.gov. This information can help oncologists and other oncology practice providers direct eligible patients to an appropriate clinical trial.
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